骨质疏松症预防与治疗的循证医学_马亚兵.pdf概念.doc

药物评价研究 第 32 卷 第 2 期2009 年 12 月135 骨质疏松症预防与治疗的循证医学研究 马亚兵，高海青*，刘新春，刘 萍，王海刚 山东大学齐鲁医院，山东 济南 250012 摘 要 目的：为骨质疏松症的预防与治疗提供循证医学证据。方法：循证检索 PubMed 的 Clinical Queries，获取骨质疏 松症预防与治疗相关文献，将检索所得文献有选择性的阅读消化提炼，获得可信循证医学证据。结果：不同的检索 策略分别获得文献 20 346 篇、2 192 篇和 454 篇。文献分析表明，原发性骨质疏松症可使用每月 po 一次伊班膦酸 盐来预防，继发性骨质疏松症可使用每三个月 iv 一次氯膦酸盐来预防，也可采用静脉滴注唑来膦酸 5 mg 或 po 5 mg 利塞膦酸盐。饮茶可作为非药物治疗预防骨质疏松的方法。饮食治疗要多食入一些含钙、磷、维生素及蛋白质丰富 的食品，以弥补体内与骨代谢有关的物质的不足。药物治疗可选用补充钙和维生素 D 钙、降钙素、二膦酸盐。还可 采用雌激素补充疗法、物理疗法等。结论：骨质疏松症的防治可采用饮食、运动、物理和药物等综合疗法。 关键词 骨质疏松症；治疗；预防；循证医学 中图分类号：R681 文献标志码：A 文章编号：1674–6376（2009）02–0135–05 Clinical Advancement of Osteoporosis Prevention and Treatment by Evidence-based Medicine Method MA Ya-bing, GAO Hai-qing, LIU Xin-chun, LIU Ping, WANG Hai-gang Qilu Hospital of Shandong University, Jinan 250012, shandong, China Abstract Objective: To provide the evidence-based medicine used in the prevention and treatment for osteoporosis. Methods: All the studies on osteoporosis were searched in Clinical Queries of Pubmed with the theme “osteoporosis” and identified to obtain the reliable evidence-based medicine. Results: There were 20 346, 2 192, and 454 studies on osteoporosis were found by different search strategies, respectively. The results indicated that primary osteoporosis can be prevented with po ibandronate once a month; secondary osteoporosis can be prevented with iv clodronateonce three months, or iv zoledronic acid (5 mg) or po risedronate (5 mg). Drinking tea is a choice in preventing and treating of osteoporosis. Dietary rich in calcium, phosphonium, vitamin, and protein can be used as the supplement of element lossing in bone metabolism. Calcium preparation, calcitonin, bisphosphonates, and estrogen can be used in the treatment of osteoporosis. Physical exercise therapy and physiotherapy can also be taken in the treatment of osteoporosis. Conclusion: Osteoporosis can be prevented and treated with diet therapy, physical exercise therapy, and physiotherapy in combination with medicine therapy a